持续不卧床腹膜透析患者肺动脉高压与超敏C反应蛋白的相关性分析

Relationship between pulmonary hypertension and high-sensitivity C reactive protein in peritoneal dialysis patients

目的研究持续不卧床腹膜透析(CAPD)患者中肺动脉高压的患病率,并探讨其肺动脉高压与超敏C反应蛋白水平的相关性。方法回顾性分析在我院腹透门诊随诊的透析时间超过6个月的CAPD患者,排除有慢性阻塞性肺疾病,严重心脏瓣膜疾病、有肺栓塞病史、左室射血分数小于50%等的CAPD患者96例,分别记录患者年龄、性别、体重、透析时间、血压,检测其超敏C-反应蛋白(HS-CRP),心脏彩超检测其肺动脉压值,按平均收缩期肺动脉压35mmHg为界。并将腹透患者肺动脉压水平与CRP进行相关分析。结果 96例CAPD患者中肺动脉压高于35mmHg的共21例(21.9%)。高肺动脉压组肺动脉压显著高于正常肺动脉组(43.0±9.13 vs 18.22±5.24,P<0.05),对腹透患者肺动脉压值和CRP水平进行直线相关分析,Pearson相关系数r=0.38,P=0.036。结论 CAPD患者中肺动脉高压发生率较高,其持续慢性炎症状态可能与其肺动脉压增高有关。

Objective To investigate the relationship between pulmonary hypertension and high-sensitivity C reactive protein（CRP）in patients on continuous ambulatory peritoneal dialysis（CAPD）.Method The study was performed in 96 patients undergoing CAPD more than 6 months.Patients that had chronic obstructive pulmonary disease,severe mitral or aortic valve disease,connetive tissure disease,history of pulmonary embolism,left ventricular ejecion fraction〈50% were excluded.The information of age,sex,height,weight,time on CAPD and sitting blood pressure was collected.CRP was mesured.All patients were examined using echocardiography.PAH was defined as systolic pulmonary artery pressure（PAP）〉35mmHg at rest.Results PAH was detected 21（21.9%） of the 96 CAPD patients.Mean systolic PAP was significantly higher in patients with PAH than in those without PAH（43.0±9.13vs18.22±5.24,P〈0.05）.The CRP levels were correlated with PAP in CAPD patients（r=0.38,P=0.036）.Conclusion PAH is a frequent cardiovascular complication in CAPD pateints.Therefore,continuous systemic inflammation may be enhanced to development of PAH in CAPD patients.